10A NCAC 09 .0601 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0302 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/11/2025 Number Present: 45 Completed Date: 8/11/2025 Age: From 0 To 5 Total Minutes: 320 Time In: 10:25 AM Time Out: 03:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition, nap, and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-seven percent (87%) as of 7/1/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Play Center, Inc., is current/active as of 7/1/2025. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/22/2024. The last fire drill was practiced on 7/28/2025. The last lockdown drill was practiced on 6/12/2025. The last playground inspection was documented on 7/16/2025. The last fire inspection was approved on 8/5/2025. The last sanitation inspection was conducted on 6/2/2025 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Banks Street. Space 1B the group of three-year-old children were engaged in group time on the carpet with the staff member. After group time, the group transitioned to music and movement. During nap time, staff were standing in a central location to easily observe all the children at once. The staff used low lighting and soft music during nap time. While monitoring the classroom, I observed the attendance was not completed for today. The administrator corrected this during the visit. Space 1A the group of infants were engaged in individual feeding, staff singing, two (2) were in crib sleeping, and another was looking at themselves in a mirror. While monitoring at nap time, two (2) infants sleeping last sleep check was completed at 1:15p and at 1:37p I observed the sleep check was not completed. The staff completed the check during the visit. Space 2 the group of one year old children were engaged in free play with blocks and dollhouse. One (1) staff was conducting routine diaper changes. The other staff was engaged in play with the children. After free play, the group prepared for lunch. Space 3 the group of two-year-old children were engaged in free play with magnetic tiles, magnetic animals, linking ladders, legos, and pop it toys. One (1) staff member was engaged in play with the children and the other staff member was conducting routine diaper change. After free play, the children prepared for lunch. While monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Space 4 the group of three- to four-year-old children were engaged in free play. After free play, the group cleaned up to use the restroom and prepare for lunch. While monitoring nap time, I observed the lighting in the back of the classroom was too dark to assess the children's wellbeing. We discussed adding a battery powered light or opening a closet door to have lighting in the back of the room. Also, I observed a mop with mop solution sitting beside the bathroom door accessible to children. We discussed when the mop is out in the classroom, the staff must stay with the mop or the mop must be locked at all times. Lunch today consisted of chicken nuggets, green beans, pears, bread, and milk. The program does not provide transportation. While monitoring staff files, I observed annual professional development plans and staff evaluations were completed late. Also, staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Staff member hired 3/27/2024 emergency information and health questionnaire was completed late. While monitoring children’s files, one (1) child enrolled 2/25/2025 immunization report was not submitted on the first day or within the first thirty days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. One (1) child’s emergency information was not updated annually. The last update was conducted on 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-out the child to have them update the form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. Space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. 15A NCAC 18A .2821(e) 807 A safe indoor and outdoor environment was not provided for the children. Space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. .2820(b) 871 Center staff did not comply with the safe sleep policy. Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. 10A NCAC 09 .0606(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. 10A NCAC 09 .0514(f) 1301 Center did not maintain a record of daily attendance. Space 1B daily attendance was not completed for today. GS 110-91(9) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. .0802(c) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. 10A NCAC 09 .0302(d)(2) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. .0607(f) Technical assistance was provided as follows: Item 614 space #3, while monitoring nap time, I observed three (3) cots placed in the dramatic play center less than eighteen (18) inches apart. One (1) cot measured sixteen (16) inches from another cot, and one (1) measured fourteen (14) inches from the other cot. During the visit, the staff member added the solid barrier between the cots. Rule reference: .2821 (e) Item 807 space #4 the lighting in the back of the classroom was too dark to assess the children’s wellbeing as they were asleep. We discussed adding a battery powered light or turning on the light in the closet to assist with lighting. Rule Reference: 0601 (e) Item 840 space #4 mop with mop solution was left unattended during nap time. The staff member left the mop beside the bathroom door and walked to the storage closet. We discussed to remind staff that the mop will need to stay with them or be locked at all times. Rule Reference: .2506 (c) Item 871 Space #1A while monitoring at nap time, two (2) infants sleeping sleep last sleep check was completed at 1:15p and at 1:37p the sleep check was not completed. The staff completed the check during the visit. Rule Reference: .0606 (a). Item 1034 Staff member hired 3/27/2024 health questionnaire was not completed annually. The last health questionnaire on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence: .0701 (a) Item 1035 Staff member hired 3/27/2024 emergency information was not completed annually. The last emergency information on file was dated 8/9/2024. The staff member completed the health questionnaire during the visit. Rule Refence:.0701 (a) Item 1232 staff member hired 6/24/2019 on-going training hours were not completed. The staff member was required 10 hours and documentation on file documented 9 hours of on-going training. We discussed sending out a reminder when staff training hours are due. Rule reference: .0514 (f) Item 1301 Space 1B daily attendance was not completed for today. The administrator completed during the visit. Item 1311 Child enrolled 6/10/2024 emergency information was not updated annually. The last emergency information on file was dated 6/8/2024. The administrator stated that she has sent numerous reminders to the parent and still has not received it. I recommend stopping the parent prior to sign-in the child out to have them update the form. Rule reference: .0802 (c) Item 1323 child enrolled 2/25/2025 immunizations were not submitted within thirty (30) days of enrollment. The immunizations on file were dated 4/18/2025. We discussed creating a reminder for parent and creating a spreadsheet to keep up with the dates that items are needed by for quick reference. Rule Reference: .0302(d)(2) Item 1825 Staff member 3/27/2024 annual EPR plan review was conducted late. The last annual review was conducted on 8/9/2024. The staff member completed the EPR review on 8/11/2025. The administrator stated that the staff member was out during the staff meeting conducted on 8/8/2025. Rule Reference: .0607 (f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 8/25/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed reviewing with staff the storage of hazardous products, and nap time requirements. -We reviewed cot placement and the thickness of mats. - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 50 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:30 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/22/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last fire drill was practiced on 2/27/2025. The last emergency drill, lockdown drill, was practiced on 12/19/2025. The next emergency drill is due by the end of March. The last fire inspection was approved on 8/8/2024. The program’s most recent sanitation inspection was completed on 10/31/2024, with four (4) demerits. The last lead and asbestos testing was completed on 7/25/2023. The facility was due to be completed by 7/25/2026. I recommend beginning the process now. The Emergency Medical Care Plan is posted and current. Space #1B- The group of three-year-old children were engaged in outdoor gross motor play. After gross motor play, the group transitioned indoors to prepare for lunch. While monitoring the indoor space, I observed one (1) Aquaphor medication form that expired on 1/18/2025. When I asked the administrator about it, she stated that the staff would need to have the parents update the form. The administrator removed the Aquaphor form the classroom to hold in the office until the parents picked up the medication or updated the form. Space #1A- The group of infants were engaged in exploring the environment on the floor, nap, and individual feeding. Staff were meeting the individual needs of the children. While monitoring mediations, I observed one (1) permission to administer medication missing the dates to administer the medication. When I asked the staff, the staff stated the parent completed the form in January. The staff was able to add the dates to the form during the visit. Space #2- The group of one year old children were engaged in outdoor gross motor play and three (3) children were indoors for a routine diaper change. While monitoring the indoor space, I observed one (1) can of Lysol unlocked in a cabinet above the sink, one (1) inhaler on the white shelf below five (5) feet, and one (1) unlabeled bottle sitting on top of the cubbies. The can of Lysol was moved to locking cabinet during the visit. The inhaler for the staff member was discussed and the staff member moved the inhaler to on her person. We discussed that the storage on her person was not appropriate due to it could fall out and a child could pick it up. We also discussed that given the age of the children is one years old the inhaler was inaccessible but was not stored five (5) feet up or on the staff members person. We discussed that moving forward, the inhaler would need to be stored up five (5) feet and it would need to be labeled staff for others to know that the inhaler was not for a child. The unlabeled bottle was emptied and stored in the cubby until the parent picks up this afternoon. We discussed that the bottle should be emptied or sent back home with the parent. Space #3- The group of two-year-old children were outside gross motor play. After the gross motor play the group transitioned indoors to wash hands and prepare for lunch. Space #4- The group of three- to four-year-old children were preparing to go outside. Once outside, the group engaged in play with the sand box, digging, and balls. Lunch today consisted of pizza, corn, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #2, one bottle was observed unlabeled sitting on top of the cubbies. 15A NCAC 18A .2804(d) 536 Formula and other beverages which require refrigeration were not identified for each child or properly refrigerated. In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. 15A NCAC 18A .2804(d) 847 Parent's medication authorization did not include required information. In space #1A, one (1) permission to administer form was missing the dates to administer. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. .1102(d) Technical assistance was provided as follows: Item #533- In space #2, one bottle was observed unlabeled sitting on top of the cubbies. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item #536- In space #2, one bottle was observed unlabeled sitting on top of the cubbies not refrigerated. When asked the administrator stated that the child brings it in with them but the child uses a center provided sippy cup throughout the day instead of a bottle. We discussed sending the bottle back home with the parent, or dumping the bottle out and storing it up until the end of the day for the parent to pick up. Rule Reference: 15A NCAC 18A.2804(d) Item # 847- In space #1A, one (1) permission to administer form was missing the dates to administer. When discussed with the teacher, she stated the form was just updated in January. The teacher corrected the from during the visit by adding the dates. Rule Reference: .0803(4)&(6-9) Item #849- In Space # 1B one (1) Aquaphor permission to administer medication form expired on 1/18/2025. We discussed that the staff conduct monthly medication checks. Staff need to be sure to look closely at the medication form dates and the expiration dates of the medication to ensure that the form and mediation is in compliance for continued use. Rule Reference: .0803(12) Item #1048- Staff member hired 11/18/2024 First Aid was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference: 10A NCAC 09 .1102(c) Item #1049- Staff member hired 11/18/2024 CPR was not completed within the first ninety (90) days of employment. When discussed with the administrator the training has been rescheduled twice due inclement weather and sickness. The training is rescheduled for 3/4/2025. Rule Reference:10A NCAC 09 .1102(d) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/17/025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff medications- When a staff member has an emergency medication, the medication would need to be stored appropriately five (5) feet up and be labeled. Bottles brought in from home should be labeled and stored appropriately. If the child is in a classroom that does not use a bottle, I suggest sending the bottle back home with the parent or dumping the remaining milk out and storing the bottle up for the parent to pick up at the end of the day. Hazardous products- we discussed reviewing with staff members the appropriate storage for hazardous products. Items with keep out of reach of children can be stored five (5) feet up unlocked. If items have keep out of reach of children with multiple warnings, the items must be locked. If items are manufactured in an aerosol can, the item would need to be locked at all times. Reminders- Staff members MW and KE First Aid and CPR training is due by 7/2025. Staff member RG qualifying letter is due by 12/2025. Staff member AS qualifying letter is due by 8/10/2025. Staff member PM qualifying letter is due by 6/23/2025. Staff member EH health and safety trainings are due by 6/2025. Staff member SB health and safety trainings are due by 8/2025. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0302 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-86 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/22/2024 Number Present: 53 Completed Date: 8/22/2024 Age: From 0 To 5 Total Minutes: 285 Time In: 09:15 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Dixie Metcalf, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Dixie Metcalf, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/21/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc, is Active- Not Current as of 8/21/2024. I spoke with Ms. Metcalf and Ms. Gilliam regarding the status and she stated they were not aware of what was needed. Ms. Gilliam reached out to her accountant and the accountant stated that the annual report was filed in January 2024 and payment was submitted by the end of January or first of February 2024. The accountant stated that the State is short staffed and they are behind on processing the annual reports and payments. The accountant is checking to see if the check has cleared the bank. They assured me that this has been taken care of and will get resolved. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 8/29/2023. The last fire drill was practiced on 8/21/2024. The last lockdown drill was practiced on 6/19/2024. The last playground inspection was documented on 7/29/2024. The last fire inspection was approved on 8/8/2024. The last sanitation inspection was conducted on 3/7/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans is current and up to date as of 8/13/2024. The approved curriculum for four-year-old children is Banks Street. Space one b (1B) the group of three-year-old children were engaged in outdoor gross motor play. Space one a (1A) the group of infants were engaged in indoor and outdoor gross motor play. One (1) staff member was outside with two (2) children engaged in play on a blanket in the shade. One (1) staff member was indoors with three (3) children. One (1) child was in their crib asleep on their back, one (1) child was being held by the staff member and engaged in bottle feeding, and one (1) child was on the floor engaged in play with the toys. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in water break outside on the playground. After their water break, the children transitioned back to gross motor play outside. While monitoring the indoor space, I observed the daily attendance not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. Space three (3) the group of two-year-old children were lining up and preparing to go outside for gross motor play. Once outside, the children engaged in play with trucks, bubbles, and sand. One (1) staff member was engaged in play and conversations with the children while blowing the bubbles. One (1) staff member was engaged in play with the children digging in the sand while actively supervising the children. Space four (4) the group of three- to four-year-old children were engaged in free choice center play with free art, Mr. Potato head, legos, and musical instruments. After free play the children transitioned outdoors for gross motor play. While monitoring the indoor area, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. Lunch today consisted of meatballs, mixed vegetables, orange, bread, and milk. There are twenty-five (25) staff members. I monitored seven (7) new staff member, one (1) substitute, and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty- seven (57) children enrolled. I monitored six (6) of children’s files and the children’s record checklist was completed during the visit. The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #4, one (1) electrical outlet on the power strip was observed uncovered 10A NCAC 09 .0604(c) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. .1102(f) 1301 Center did not maintain a record of daily attendance Space #2, the daily attendance was not completed for today. GS 110-91(9) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. -Space #4, one (1) electrical outlet on the power strip was observed uncovered. The administrator covered the outlet during the visit. I recommend conducting a daily classroom check to ensure that all outlets are covered with a safety cover. Item #1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (f) In centers that are licensed to care for infants, the child care administrator and any child care provider scheduled to work in the infant room shall complete ITS-SIDS training. ITS-SIDS training shall be completed within two months of an individual assuming responsibilities in the infant room and every three years thereafter. Child care administrators, as defined in G.S. 110-86(2a), shall complete ITS-SIDS training within 90 days of employment and every three years thereafter. Completion of ITS-SIDS training shall be included once every three years in the number of hours needed to meet on-going training requirements in this Section. At all times, one child care provider who has completed ITS-SIDS training shall be present in the infant room while children are in care. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. -Staff member hired 5/7/2024 did not complete ITS-SIDS training within two (2) months of employment. The training was due to be completed by 7/7/2024. The training was completed on 7/18/2024. I recommend documenting training due dates on a calendar to help remind you when each training is due by. Item #1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; -Space #2, the daily attendance was not completed for today. The administrator took the attendance to the staff and had them complete the attendance for today during the visit. I recommend having staff complete the daily attendance as the children arrive. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/5/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. -Review with staff the importance of supervision and ensuring that children are supervised at all times. -Check driver’s license when someone picks up a child to ensure that the child is being picked up by and approved person on the pick up list. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0803 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 54 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 09:25 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Dixie Metcalf, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Vanessa Gilliam, Owner, during the visit. A signed copy of the visit summary was left on-site with you. Your program currently operates with a Four (4) Star Rated License effective 7/17/2019. The permit restrictions were in compliance including first shift, meets enhanced ratios, meets enhanced space. Dixie Metcalf, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 8/29/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions When I arrived the children in space one b (1B) the group of three-year-old children were engaged in free play blocks, puzzles, and dramatic play. After centers, the children cleaned up and prepared to go outside for gross motor play. While monitoring medications child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. Space one a (1A) the group of infants were engaged in free play on the floor, routine diaper changing, bottle feeding, and one (1) child was sleeping. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in gross motor play outdoors with shovels, sand, sliding, and musical toys. One (1) teacher brought half of the children in to conduct routine diaper changes while the others remained outside with the other teacher. Space three (3) the group of two- to three-year-old children were engaged in free play with boxes in the blocks center, dramatic play, and sensory bin. Space four (4) the group of three to five year old children were engaged in free play with art, manipulatives, blocks, and manipulative. After free play, the children cleaned up and prepared to go outside. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of meatloaf, potatoes, bread, and milk. The last fire drill was practiced on 1/23/2024. The last emergency drill, lockdown drill, was practiced on 12/14/2023. The last fire inspection was approved on 8/28/2023. The program’s most recent sanitation inspection was completed on 8/30/2023, with eight (8) demerits. The Emergency Preparedness and Response plan is current as of 8/9/2023. The Emergency Medical Care Plan is posted and was updated in 1/22/2024. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. No new staff have been hired since the last visit. One (1) existing staff file was monitored for on-going training hours that were not due to be completed during the annual visit. Staff member JG hired 2/14/2022 required on-going training hours is ten (10) hours. The staff member brought forward five (5) hours and had five (5) hours remaining to complete by 2/14/2024. The staff members’ on-going training hours were completed late. The completion certificate was dated 2/17/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. .0803(12) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. .1103(a) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/6/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #1B child HD Babyganic sunscreen expired 1/2024 and the permission to administer medication form expired 1/1/2024. The administrator removed the medication and discarded it during the visit. I suggest having the staff complete a monthly check of all medications to ensure the medications and medication forms have not expired. If the medication or form has expired, move the medication to a locking cabinet until the medication can be returned to the parent or the form can be updated updated. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training: 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training: 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training: 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training: 15 clock hours If none of the other criteria in this chart apply Required Training: 20 clock hours - Staff member JG hired 2/14/2022 had five (5) hours of on-going training hours during the annual compliance visit on 8/29/2023 and was due to complete five (5) hours of on-going training by 2/14/2024. The staff members completed their on-going training hours three (3) days late on 2/17/2024. Review staffs on-going training every two (2) to three (3) months to ensure the staff is on track for obtaining their required training hours prior to their employment anniversary date (ex. Staff member hired 2/14/2022 would need to have training hours completed by 2/14/2024). Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Sensory bin items should not include food item to prevent any cross contamination and the spread of germs. The staff could conduct a group activity where the children can explore the each item as a group ensuring proper hand washing is conducted and contaminated items are discarded properly. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0801 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2318 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: NESSA'S YOUNG'UNS NATURAL PLAY CENTER Facility ID: 45000372 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 49 Completed Date: 8/29/2023 Age: From 0 To 4 Total Minutes: 305 Time In: 09:45 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Dixie Gilliam, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Today, Dixie Gilliam, Administrator was on-site and available to assist me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 8/25/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Business Corporation, Nessa’s Young’uns Natural Playcenter, Inc., is current/active as of 8/25/2023. Permit type – Four (4) Star Rated License, issued 7/17/2019. Special Services/Restrictions – First shift, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 9/16/2022. The last fire drill was practiced on 8/17/2023. The last lockdown drill was practiced on 6/14/2023. The last playground inspection was documented on 7/25/2023. The last fire inspection was approved on 8/28/2023. The last sanitation inspection was conducted on 3/31/2023 with eleven (11) demerits for a superior classification. The Emergency Medical Care plan was posted and current as of 8/11/2023. The Emergency Preparedness and Response plans is current and up to date as of 8/9/2023. The approved curriculum for four-year-old children is Banks Street. Upon arrival, I introduced myself to the Administrator. When I arrived the children in space one b (1B) the group of two- to three-year-old children were engaged in outdoor gross motor play splashing in the mud puddles with their rain boots, and toy plates. After gross motor play, the group transitioned indoors to wash hands, change clothes due to the rain and splashing in the mud puddles. Then the group transitioned to free choice center play with dress up, pretend food, and magnetic tiles. Space one a (1A) the group of infants were engaged in tummy time on the floor, and routine diaper changing. The staff were meeting the individual needs of the children. Space two (2) the group of one year old children were engaged in story time with the staff member, free choice center with the dollhouse, toy cars, and blocks. Space three (3) the group of two- to three-year-old children were engaged in free art, and group music and movement. Space four (4) the group of three to four year old children were engaged in free choice center play with blocks, dramatic play, magnetic tiles, scales, and puzzles. All staff were engaged with the child in a positive and nurturing manner. Staff actively supervised the children while engaging in play. Lunch today consisted of bbq chicken sandwich, mixed vegetables, pineapple and milk. All medications were reviewed in each space. There are twenty-two (22) staff members. I monitored three (3) new staff member and two (2) existing staff member files. Staff and training worksheet was received via email prior to today’s visit. There are fifty-five (55) children enrolled. I monitored five (5) of children’s files and the children’s record checklist was completed during the visit. We reviewed the facility information and updated the email address. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. 10A NCAC 09 .0604(c) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. 10A NCAC 09 .0803(1)(a & b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. .0802(c) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. .2318 (7) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. .0801(b) Technical assistance was provided as follows: Item #812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. - In space #1B, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the lamp in. In space #2, one (1) outlet was uncovered near the hand washing sink. The administrator plugged the charger in during the visit. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; - In space #4, child DH did not have a completed permission to administer medication form on-site for Benadryl. The administrator removed the medication from the classroom to store in the office until the appropriate form has been completed. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member MR hired 8/18/2020 personnel file did not contain an annual staff evaluation. The evaluation on file is dated 8/24/2022. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. - Child ET enrolled 8/25/2022 and RR enrolled 8/20/2020 did not have an annual update of the emergency medical care information on file. Item #1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION All records required in this Chapter shall be maintained for review by representatives of the Division as specified in G.S. 110-91(9), Rule .0304(g) of this Chapter, and as follows: (7) Each child care center shall retain records for personnel as follows: Type of personnel record: For at least one (1) year after employee is no longer employed Application for Employment x Rule .0302(d)(1)(A) Staff Medical Report x Rules .0302(d)(1)(C) and .0701(a) Health Questionnaire x Rules .0302(d)(1)(C) and .0701(a) Proof of Tuberculosis Test or Screening x Rules .0302(d)(1)(C) and .0701(a) Staff Emergency Medical Care Information x Rules .0302(d)(1)(C) and .0701(a) Evaluation of Emotional and Physical Fitness x (as applicable) Rule .0701(b) - Staff member MW hired 6/5/2023 personnel records were not maintained. The personnel file did not contain the emergency information form completed on or before the first day of work, but did contain the updated emergency information form completed on 8/11/2023. When asked about the emergency information form completed on 6/5/2023 it was stated that the form was shredded/thrown away since the staff member updated the form on 8/11/2023. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #4, child DH food allergy action plan was not updated annually. The food allergy action plan on file expired on 5/4/2022. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/12/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Resuming Rated License- Resuming Rated License- The facility is in cohort 2. The year of preparation began July 1, 2024, and will end on June 30, 2025. The year of assessment will begin July 1, 2025, and end June 30, 2026. Be sure to take advantage of the preparation year assessment during your preparation year. - Staff member MW hired 6/5/2023 First Aid and CPR training is due by 9/3/2023. - I recommend keeping a file for personnel documents that are updated annually to ensure that you maintain the personnel information until one (1) year after the employee terminates employment with your facility. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times